An exploration of self-evaluation of induced temporal and spatial gait asymmetry in neurotypical young adults

BACKGROUND: Deeper understanding of how neurotypical adults perceive induced spatial (SGA) and temporal asymmetry (TGA) of their gait can inform augmented feedback-based rehabilitation interventions for post-stroke gait asymmetry. RESEARCH OBJECTIVES: 1) Describe accuracy of self-evaluation of SGA and TGA; 2) compare the probability of correctly self-evaluating TGA and SGA. 3) compare physical activity levels, plantar sensation, and joint position sense between those who accurately vs inaccurately self-evaluate gait asymmetry. METHODS: Thirty-three neurotypical adults underwent a unilateral limb-loading protocol to induce asymmetry while walking on a pressure-sensitive mat. Self-evaluation of the presence and direction of asymmetry was collected with a questionnaire and compared to measured asymmetry (taken as ground truth). The probability of correctly self-evaluating asymmetry was investigated with generalized linear mixed modelling. Pairwise comparisons were made and odds ratios with 95% confidence intervals were calculated to determine whether self-evaluation was more likely to be correct for SGA or TGA. Group differences in physical activity, joint position sense, and plantar sensation were examined using Wilcoxon signed-rank tests. RESULTS: Self-evaluation of TGA direction had lower odds to be correct when attention was directed to single limb stance (SLS) than swing time (SwT) (OR = 0.13 [0.04, 0.40]). Self-evaluation of asymmetry had lower odds to be correct for SGA than TGA for both presence (0.09 [0.02, 0.51]) and direction (OR = 0.18 [0.06, 0.58]). SIGNIFICANCE: These preliminary findings suggest self-evaluation of TGA is more accurate than SGA and directing attention to the swing phase may facilitate more accurate self-evaluation of TGA. These findings provide context for future work that will investigate self-evaluation of gait asymmetry in people with stroke. Such information can inform the development of extrinsic feedback-based interventions for post-stroke gait asymmetry.